?Dear Abby? confirms importance of an RDHAP to care for those with special needs.

On May 30 (San Francisco Chronicle), Dear Abby answered a letter from a concerned daughter regarding her mothers? oral health care needs while battling Alzheimer?s. (http://www.sfgate.com/entertainment/article/Dear-Abby-Nursing-home-residents-often-lack-6295372.php) Abby?s response explained the role of the dental hygienist as the provider for such patients. Individual states determine the scope of practice for their providers. Here in California, it is the Registered Dental Hygienist in Alternative Practice, or RDHAP, as the primary provider for patients? with special needs, such as this writer’s mother. ?Too often, the oral healthcare needs of the homebound and special needs patients are not addressed,? states California Dental Hygienists? Association (CDHA) President Lygia Jolley, RDH, BA. ?Many caregivers are unaware of the RDHAP profession and the services that they can provide,? she adds. ?Abby? goes on to detail the work hygienists? can do in such settings, and discusses the change in workforce models currently taking place in many states to further expand this needed oral care.

Registered Dental Hygienists in Alternative Practice (RDHAPs) are licensed in the State of California as dental hygiene professionals who specialize in treating patients with special needs, including patients with mental or physical disabilities whose health conditions limit their abilities to access quality preventive and periodontal oral hygiene care. They purposely reach out to populations who have difficulty accessing care within a traditional dental office. ?The RDHAP provides patients the same type of professional preventive care they would receive in a dental office but allows patients to receive this care conveniently in their own homes,? states Jolley.

RDHAPs provide their services for residents of skilled nursing facilities, disabled individuals, homebound elderly, pregnant women, and children in school settings. For those loved ones and family members living in a long-term care facility or homebound due to age or illness, oral health care contributes to overall health and well-being. With their own mobile units, RDHAP?s bring care to those who may not otherwise receive any type of dental care.

Be sure to include an RDHAP within your provider team, when you are considering services and care. To find an RDHAP in your area, visit the CDHA website at http://www.CDHA.org/RDHAP directory, or email: info(at)cdha(dot)org.

The California Dental Hygienists? Association (CDHA) is the authoritative voice of the state?s dental hygiene profession. The organization was established 30 years ago when two regional associations merged to form a unified professional group. CDHA represents thousands of dental hygienists.

When you live with a Golden, you get very accustomed to fur tumbleweeds skittering across the floor, wet footprints marking the tile, and a standing order for lint rollers. It just comes with the territory.

I’ve also become somewhat of a connoisseur of brushes; brushes for removing undercoats, for dematting, for general purpose grooming. So when I was sent an unassuming Groom Genie to test out, I figured, “here we go, another one for the grooming bin.” Then I tried it.

I don’t know what wizardry went into its construction, but this little brush is the bomb. Its handleless shape is meant to mimic you stroking your dog or cat, adding to its calming properties, but the real genius is in its bristles. Its bristles are different heights and have enough give so that it works by detangling without pulling. Brody leans into it and does that happy “hrrrmmm mmmmm hmmmm” groan when we pull it through his fur, even the long feathers that tend to get tangled.

My initial response was to run it through my daughter’s tangly hair, but before I could do that they also sent me a Knot Genie (the human version) to try out. My sister and I took turns grooming each other like ecstatic chimpanzees before declaring both of them the bees knees. It was the only brush that could detangle my mom’s hair without hurting her after 10 days of being unable to touch it due to her surgery, and for that alone I say, THIS ROCKS.

The Neat Treat is a Duo

The Paw Sponge is part two. Do you ever do that thing during rainy season where you have to cordon off the back door and tackle the dog, trying your best to wipe all the mud from between his toes with a dishtowel before he goes prancing over the carpet? Or those little wipes that only slick the mud around?

The Paw Sponge is an elegant solution: a mitten-like sponge that slips over the paw. Squeeze, twist, clean. I’ve also started recommending them for dogs with pododermatitis who need regular cleanings with diluted chlorhexidine or other medicated shampoos. This is one of those “Why didn’t anyone think of this sooner?” dog devices.

Between the Groom Genie and the Paw Sponge, the Neat Treat package will keep your pup looking his finest for all those summer parties. Yours FREE for all those generous All Dogs Go to Kevin preorders.

The Neat Treats are limited quantity, and only available until July 14th- so if you want one, grab one fast!

How to Claim a Neat Treat

1. Preorder 2 copies of All Dogs Go to Kevin (if you want them signed, get them from Warwicks)

4. We’ll follow up in the coming weeks to confirm the order!

Costa Rica: President adds a piglet to the palace
Daniela can rest easy now that she's a presidential piglet – Mr Solis says she won't end up on the dinner table, but instead will be "the first pet of the republic". He likened the piglet to US President Barack Obama's pets, and the turkey that is …Read more on BBC News

Ex-squeeze's book puts Hef in wringer
In exchange for "free" room and board, a leased new car and a $ 1,000 weekly clothing and grooming allowance, Holly, as well as a rotating roster of six other girlfriends, lived in the stately but "neglected" mansion with old, pet-stained carpet as kept …Read more on NWAOnline

Pet insurance is gamble in changing market
The North American Pet Health Insurance Association estimates Americans will spend more than $ 15 billion on veterinary bills this a year, yet have been most reluctant to jump into the pet insurance market. The reason: conflicting opinions about when …Read more on Green Bay Press Gazette

Lacey’s fur has almost all grown back in on her back leg. She has a small hard lump at the top of her skin graft that I’ve been telling myself is scar tissue. It hasn’t changed in size at all so we are just keeping an eye on it for now.

Coulee is still on a restricted exercise diet. Everything other than a 15 minute walk makes her stiff so we just go every few days for about 30 minutes or so. We don’t play any fetch at all anymore but will occasionally engage in a game of catch. It isn’t quite the same, but she still enjoys it.

I’m enjoying my summer off from photographing events. Every time I see an agility photo I just smile and am thankful that I’m not spending weeks at the computer this summer. I am however increasing my photography rates and sent my clients a notice about that, so I’m suddenly booking lots of sessions before the rates go up. LOL

We have not been out camping nearly as much as I’d hoped yet, but we still have lots of time. We are still trying to figure out our summer vacation… We can’t decide what to do or where to go but we are brainstorming ideas.

Patients who suffer from dental anxiety can now turn to Dr. Tokarczyk for treatment. Dr. Tokarczyk offers sedation dentistry in Springfield, MO at his practice, for all patients from Nixa, Branson, and Ozark Missouri and Harrison, Mt. Home, Arkansas. The doctor?s hope is that patients who would otherwise opt to forgo treatment will take the opportunity to receive the dental care they require using sedation dentistry. As a State Examiner for the IV Conscious Sedation Committee for the Missouri Dental Board, Dr. Tokarczyk understands the value of sedation dentistry and how it can help patients; he encourages qualifying patients with anxiety to consider the procedure.

Fear of the dentist has been around just as long as the profession itself. This may be connected to the earliest forms of dentistry, which did little to relieve pain associated with treatment. Although many techniques today are performed to reduce and eliminate pain and discomfort whenever possible during treatment, some patients fear of pain is so overwhelming they would rather subject themselves to dental disease instead of seeking a resolution. The fear of dental induced pain is often so overwhelming for some patients that they fail to realize the detrimental effects of delaying their dental treatment.

When patients receive sedation dentistry in Springfield, MO with Dr. Tokarczyk, they are given their medication intravenously, or directly into the bloodstream. The medicine relaxes and calms patients with dental anxiety, so they no longer feel anxious. Regular pain relievers are also utilized, just as if the patient were having the procedure without sedation, which eliminates the majority of unnecessary pain. Although patients remain awake and able to answer questions, they may not recall undergoing the procedure once the sedation has worn off. Patients who undergo sedation dentistry are not able to drive for some time following a procedure, so a friend or relative must accompany them to their appointment to bring them home safely.

Dental Anxiety is a real concern, and can be crippling to those who want to properly address their oral health. Those who would like to learn more about sedation dentistry in Springfield, MO, should visit Dr. Tokarczyk?s website for more information, or set up a consultation with him to determine if they are a good candidate for conscious sedation.

About the Doctor

Dr. Leo A. Tokarczyk is a periodontist dedicated to providing excellent care to patients in Springfield, MO. Dr. Tokarczyk offers the most current treatment options to his patients. He focuses on periodontics, implants and periodontal plastic surgery that help patients achieve a healthier mouth. His undergraduate dental degree at the University of Missouri at Kansas City, and post graduate residency at the University of Missouri at Kansas City and the Veterans Administration Hospital at Leavenworth, Kansas allowed him to develop great expertise in periodontal treatment. He is an active member of The American Dental Association, Missouri Dental Association, Greater Springfield Dental Society, and American Academy of Periodontics. To learn more about the services offered by Dr. Tokarczyk please visit his website at http://www.springfieldperioimplants.com or call (417) 882.2880.

Some of you have kindly asked how ‘Ours’ = Bear (pronounced Orse) my newly adopted dog is coming along. Well here he is after two months here – he loves the garden, he plays BUT he is still terrified of any visitor and lives in fear of the someone coming through the front gate. But there is progress – and of course I’m in love!RIVIERA DOGS

As you guys know, I’ve been working with the Sisterhood of Motherhood campaign for the last three months, sharing some of my experiences with parenting. My first post talked a little about the project itself, as well as what I’d learned transitioning to solid foods for Essley last year, and I shared some of our favorite baby food recipes. In the second installment, I got a little more personal and discussed the common occurrence of judgment among parents, along with some ideas I had for supporting other moms and dads through acts of kindness. For today’s post, the final in the series, I’ve decided to really break down the walls and share the details of Essley’s and my breastfeeding journey. Some of these details are sparkly and endearing. Others are painful and ugly. But they’re all here.

I’ll start out by saying that although I enjoy sharing bits and pieces of my life (obviously; I’m a blogger), I do choose to keep the majority of my family’s and my life private. The journey of feeding a baby is an profoundly personal one. The experience of every parent and baby is different, and the struggles and triumphs that accompany it can be highly emotional. Unfortunately, I’ve found that the judgment that I’ve discussed here in the past seems to be at its greatest when it comes to feeding. Parents are scorned for giving their babies formula instead of breastmilk. Mothers are frowned upon for stopping breastfeeding early or for continuing to breastfeed their babies beyond what is considered socially acceptable in this country. Dirty looks (or worse) are given to moms who breastfeed their babies in public settings. I was shocked as a new mother when I realized how opinionated people were about this subject, to the point that, at first, I was scared to even discuss my personal experiences. Almost a year and a half later, I’ve decided to open up about our journey. I’m well aware of the potential of judgmental response to this (because, as you will learn more about in a minute, I’m still nursing a toddler who many Americans would consider to be too old to still receive breast milk). But my hope is that by me being transparent about all aspects of our experience, other parents might realize that – regardless of their own feeding journeys – they’re not alone. So here we go.

When I was pregnant, I pretty much immediately made peace with the fact that however my baby was fed, I would do my absolute best to make sure she was getting proper nutrition, because that was all I could do. My mother breastfed both my sister and me, and many of my friends had breastfed their babies, but many had successfully used formula as well. I was completely open to formula, either as a supplement or as the main food source, but my ultimate goal was to breastfeed for six months – and if I made it that far, for one year. I took a breastfeeding class, watched a ton of breastfeeding videos, and bought a breast pump. I also purchased some formula and bottles. I was prepared for whatever came my way. Or so I thought.

In late December 2013, after 30 hours of draining, soul-sucking labor, my daughter was born. I was crippled with exhaustion, and although overjoyed to finally meet her, I was terrified that I simply didn’t have the energy to breastfeed this first time – the time that you’re repeatedly warned is so important. I was also worried that she wouldn’t know what to do. Once the nurse placed her on my chest though, her instinct took over, and she began rooting. It was beautiful and amazing, and also painful and awkward. She did not latch well, and I felt like I was no help. It didn’t feel natural like I’d hoped – I felt like I was positioning her incorrectly (everything I’d learned at breastfeeding class went out the window), my nipples ached, Essley was crying, and I was shaking so hard from intense labor and lack of sleep that I could barely hold her up. The nurses had to repeatedly guide me, and at several points, I wanted to give up. Eventually, we made it work. But I wasn’t sure if it was going to work long term. It felt like 90% struggle, 10% joy.

The week that followed Essley’s birth was riddled with feeding struggles, mostly due to my own anxieties. We left the hospital on a Monday evening, and I made an appointment with a lactation consultant for Thursday afternoon, the soonest I could get in. In the days before the appointment, I can’t tell you how many times I called the hospital labor and delivery department with questions, mostly fueled by my intense (and admittedly irrational) fear that I wasn’t feeding my baby properly. She’d lost weight at her first doctor appointment, and although she seemed to be latching properly, I was convinced that she wasn’t getting enough milk. I also attempted to pump (I wanted to get used to it early, and also wanted to stockpile some colostrum), and that was its own special nightmare. Thanks to after birth hormone changes and a whole lot of sleeplessness, I was already a mess, and that first time pumping felt so foreign and strange that I full-on ugly cried the entire time I pumped, only stopping for breaths long enough to moan about how I felt like a cow. Oh, and when my milk came in that Tuesday morning (aka the biggest my boobs have ever been, times, like, a million), I was in horrendous pain for a good two days. After nine months of pregnancy that included serious issues in the final weeks, an insanely long labor, and the act of birthing itself, I had hoped that, aside from the massive lack of sleep that accompanies having a newborn, things would feel pretty damn easy. I just wasn’t expecting this. It was really difficult to process all of the uncertainty and anguish when it came to feeding.

Thankfully, after that first week, the entire process slowly improved. My lactation consultant did a test while we were there that involved weighing Essley directly before and after I nursed her, and it turned out that she was getting plenty of milk. Phew! Just knowing this allowed for an intense sense of relief, and with some of the pressure off, things instantly felt more natural. We practiced different positions for holding her while feeding, which allowed me to learn which ways worked best for her and for me as well. I also started to pump once a day so that I could freeze some of my milk, and that began to feel less awkward as well. With time and practice, Essley and I both began to genuinely enjoy breastfeeding. I can’t really put into words the immense bond I felt while nurturing my little girl in this way, and as time passed, it became better and better. I’ll never forget all of those sweet, truly extraordinary moments where Essley and I looked into each other’s eyes while we nursed. It was really, really special.

The story doesn’t stop there though – and I won’t pretend that it was all butterflies and rainbows from that point. It got easier and I learned to appreciate our nursing sessions once we got the hang of things, but breastfeeding is not pure bliss. First, I developed a condition called forceful letdown, when during certain times milk is overproduced. Essley would start to nurse and the milk would literally shoot out so intensely that she would gag and cough. Good times! I was lucky to never experience excessive nipple pain, but there were occasional instances when things got chaffed and cracked, which made the act of nursing agonizing. Then, of course, was the disaster known as the constant nighttime feedings of a cranky newborn. My daughter is as easygoing as it gets during the day, but man, this kid is a handful at night, and has been from day one. For months (and months), she wanted to nurse every hour (or more), all night long. And although my husband was able to eventually occasionally bottle feed her my breast milk (our lactation consultant was a big advocate of starting on a bottle from time to time at 6 weeks so that the baby could get used to it as an alternative to the breast), he was gone for weeks at a time for work, so there were many periods where I had no choice but to constantly wake up to nurse her. (And sleep deprivation is no joke. Yikes.) My issues with oversupply also made getting sleep a challenge, because even when Essley was bottle fed, I still had to pump or my breasts would become engorged. Then came the emotional side of breastfeeding – and I don’t mean the sweet, blissful bond I described above. Breastfeeding requires serious dedication, and especially in the months before baby is used to the bottle, the mother is at the mercy of the feeding schedule. For a long time, I couldn’t be away from Essley for more than a few hours. Ever. I was a slave to her and to the pump, and I won’t pretend that there weren’t times I wanted to hop on a plane to the freaking Bahamas for a week of solitude and fruit infused alcohol. When things got really hard, I tried to remind myself that a year wasn’t that long. We just had to try to make it a year.

On December 28, 2014, Essley turned a year old, and thoughts of the weaning process began to enter my head. She was eating mostly solid foods now, and she guzzled bottles of almond milk, so I was confident that it would be an easy process. The timing was great too, as I was leaving on New Year’s Eve to meet my husband in Atlanta for the band’s NYE show, and would be spending the night away from her (two nights, actually) for the first time. Well she took her bottles from her grandparents like a champ, but when I returned, all the kid wanted was boob. I didn’t want to force her to stop before she was ready, but I also felt pressured to wean her soon, because weaning at a year was the thing to do, or something. I mean, I’ll admit I have some hippie roots still lingering in me from my tour-the-country-in-a-van years, but I was not gonna be that super granola mom with a five year old kid hanging off her breast. I told myself we’d take things slowly, and attempt to gradually cut out feedings, and increase her bottles of almond milk and organic cow’s milk. The decrease in feedings worked, and eventually we were able to eliminate all daytime feedings except for the occasional nap time nursing session when she wouldn’t fall asleep. But after about a month, we were hit with another obstacle – Essley suddenly decided, like out of nowhere, that she was totally over bottles. Like, over them. It was sippy cups or boobs, man, and if you tried to get a bottle near that kid’s face, it was met with a swift swat of a tiny hand. It was a setback, but we kept at it until, at 15 months, she was only nursing once before bed and once in the morning. (Okay, and sometimes once in the night too. Because to this day, the kid still hates sleep. Sigh.)

At this point I’d been officially breastfeeding for 1.25 years, and although I felt like a seasoned pro, I was now faced with a whole new issue: judgment. While I got plenty of encouragement and ‘you go!’s from those who genuinely supported how long I’d been nursing, I also got my fair share of rude looks, ‘oh wow, you’re still nursing her, craaaazy’ type remarks, and plentiful unsolicited advice on how to wean this child immediately before she became a clingy, overly dependent wreck. While I felt confident in almost all of the choices I’d made as a parent, and was well past the point where I cared what anyone else thought about them, those feelings of insecurity from my early days of breastfeeding resurfaced, albeit in a different ways. In reality, although I was ready whenever she was for our nursing journey to come to an end, I never stopped enjoying it, and clearly Essley didn’t either. Our doctors had assured us that it was still beneficial, and that there was no need to stop until I decided it was truly the right time. But I still found myself dodging the subject when around others who weren’t very close friends or family as a mean to avoid feeling judged. I kept telling myself, ‘when she turns 16 months I’ll force this to stop. When she turns 17 months I’ll force this to stop.’ But then she turned 17 months, and that night, she wanted to nurse before bed, and that was that. I decided right then and there that I was going to follow the same mantra I did for all other aspects of my parental journey and do what was best for us, period. And I breastfed my toddler to sleep.

And that leads me to today. Essley will be a year and a half old on Sunday. (What? Wait, how?) She now usually falls asleep without even a suckle of breastmilk, and often wakes up in the morning ready to get right down to some serious toy playing, without even a thought of the boob entering her mind. She still nurses, even if just for 30 seconds, at some point almost every night – but it’s slowly becoming less of a regular occurrence. I’ve completely given up on pushing the issue. It all feels very easy and natural now, and I’m grateful for all of it. I’m even grateful for the judgment, because it’s allowed me to realize how much judgment exists around baby/toddler feeding choices and methods in general, which has thus enabled me to be more compassionate and empathetic myself.

Like the other triumphs in our breastfeeding journey, this, again, is not all fun and no suffering. Just try nursing a toddler as you’re being smacked in face, with a foot jabbed into your ribcage, your other nipple being twisted by a tiny, sharp fingernail before that little mouth switches frantically to the other breast, ya know, in case its missing something. Or experience for yourself the joys of being at the grocery store and feeling a little hand reaching into your bra as you lean over to grab a box of cereal off the shelf while onlookers either laugh or shake their heads. (Hey, she may only nurse at night, but my cleavage is her still her ‘safe place’ at all hours of the day, regardless of appropriateness of location.) But less-than-stellar aspects aside, as I watch our breastfeeding journey slowly reach its final period, I am able to look back over all of it (present moments included) and feel like it’s been a fulfilling, mostly joyful experience. And when it comes to the twisted road of parenting, you can’t ask for much more than that.

Are you still reading? If so, high fives and sincere thank you’s for allowing me to share this very personal experience with you. If you’re currently feeding a baby or toddler, and have felt any doubt about your own journey, I hope that reading this has enabled you to see that regardless of how or for how long we breastfeed or formula feed our babies, as long as we are nurturing them to the best of our abilities, we’re doing it right. Period.

Thank you for following along during my time working with the Sisterhood of Motherhood project! It really has been a pleasure to be a part of this campaign, and it has motivated me to want to continue to write about parenting and support among parents here on the blog from time to time. For even more inspiration in the quest of kindness, watch this amazing video for the Sisterhood of Motherhood. And if you have a feeding journey of your own, I’d love to hear about it!

Similac partnered with bloggers such as me for its Sisterhood of Motherhood Program. As part of this program, I received compensation for my time. Similac believes that consumers and bloggers are free to form their own opinions and share them in their own words. Similac’s policies align with WOMMA Ethics Code, Federal Trade Commission (FTC) guidelines and social media engagement recommendations. Find Similac on Facebook here. #SisterhoodUnite #ParentsFirst #sponsored